Modafinil And Armodafinil Safety Guide

LEGAL STUFF
Modafinil and Armodafinil are medications safely used on a daily
basis by millions of people every year. As with any medication
though they are not without their risks.
The guide and its content are being provided for
educational and informational purposes only, and
are not intended to be a substitute for your
independent
medical
judgment
or
constitute
medical advice or treatment in any way. The
content posted in this guide is not intended to
serve
as
the
primary
basis
for
making
professional medical decisions. As with all
resources, the content of this guide reflects
medical science, protocols and/or procedures at
the time of its development, but the content
should be used with the clear understanding that
continued research or practice may result in new
knowledge or recommendations. Therefore, you
should confirm the information in this guide with
other sources before undertaking any treatment or
otherwise taking any actions related to or in
reliance on such information. Your reliance upon
any content within this guide is solely at your
own risk. In no event will the publisher be
liable in any way for any decision made, or
action taken by you or anyone else, in reliance
upon the information contained on or provided
through this guide.
Information in this guide is general in nature and does not take
into account your personal circumstances.
Please do not use this information in the place
of consulting with your doctor.
TABLE OF CONTENTS
WELCOME'
4!
GENERAL'OVERVIEW'
5!
A'BRIEF'HISTORY'OF'EUGEROICS'
6!
ADRAFINIL'
MODAFINIL'
ARMODAFINIL'
6!
6!
7!
PRESCRIBED'USES'OF'MODAFINIL'AND'ARMODAFINIL'
8!
OFF<LABEL'USES'
9!
DOSAGE'
12!
MINIMUM'EFFECTIVE'DOSAGE'
14!
RISKS'
15!
SIDE'EFFECTS'
16!
FURTHER'INFORMATION'
19!
SUMMARY'
20!
APPENDIX'1:'DRUG'INTERACTIONS'
21!
DRUG'INTERACTIONS:'MODAFINIL'
DRUG'INTERACTIONS:'ARMODAFINIL'
21!
24!
WELCOME
Welcome to the Armodafinil & Modafinil Safety Guide! I’ve written
this guide with two purposes in mind. Firstly, to help you make an
informed decision as to whether the (Ar)Modafinil family of
medications is right for you. Secondly, to help make you
experience them as safely as possible. Please excuse all the
warnings, but this Safety Guide is general in nature and it just
isn’t possible for me to be sure of whether it is or isn’t specifically
going to work well for you.
I use Armodafinil daily as a way to enhance my cognitive abilities
and boost my energy levels. It has had a hugely positive effect on
my ability to study, work, and exercise. I suffer from a sleep
disorder, and without Armodafinil there is no way I could have
the quality of life I have today. If there’s one thing I can say about
Armodafinil it’s that it’s been a powerful force for a whole range
of amazing changes in my life. I only wish that I’d found out about
it sooner, particularly back when I was a University student!
One of the biggest challenges when I decided to use these
medications was (a) finding a reputable seller and (b) reputable
information. Nearly all of the information I could find was just
anecdotal user experiences – not particularly trustworthy or
relevant to me. There were plenty of places selling Armodafinil,
but they weren’t the kind of sites I wanted to even open in my
browser, let alone enter my personal information into. Plus they
often insisted on bank transfers – expensive and slow.
My main goal through this guide is to solve this information
problem and to make Armodafinil/Modafinil use safer for anyone
responsible enough to try and educate themselves. Educating
myself was slow and tedious, so I hope this Safety Guide speeds
up that process for you. I believe smart drugs like Armodafinil &
Modafinil are an incredible opportunity for both individuals and
humanity as a whole.
I hope this guide answers your questions. If you have anything to
add or ask, please contact me personally at [email protected]
- Lloyd
GENERAL OVERVIEW
Both Modafinil and Armodafinil belong to a
new class of drugs known as wakefulness
promoting agents, or Eugeroics.
There are big differences between Eugeroics
and traditional stimulants like amphetamines.
Eugeroics directly stimulate wakefulness
circuits in the brain, leading to a natural
feeling of being awake and alert. Not only are
Eugeroics more effective and longer lasting
than most stimulants, they also have fewer
side effects and are not physiologically
addictive.
This is because stimulants like amphetamines (i.e.
Adderall/Dexamphetamine)
or
methylphenidate
(i.e.
Ritalin/Concerta) work by increasing the activity of the central
nervous system – while Eugeroics are believed to just change
chemicals in the brain.
Rather than a ‘high’ the experience using Eugeroics is closer to
losing any perception of ‘tiredness’. It is like the brain fog has
lifted and that generally means the end of procrastination, for me
at least!
The wakefulness effects of Eugeroics have led to them being
commonly used to treat sleep disorders. However, they also have
a wide range of cognitive enhancing effects. For this reason they
have also become popular amongst people who require extra
focus, creativity or energy. Many students, scientists,
entrepreneurs, programmers and executives regularly use
Eugeroics to improve their performance.
However, not all Eugeroics are alike, they all have different pros
and cons. Some may be more effective for certain conditions,
while others have fewer side effects. Let me share with you a
brief history and list of the more common Eugeroics.
A BRIEF HISTORY OF EUGEROICS
Eugeroics are a relatively new class of drugs, having only been
available since the late 1970’s. However, they have only become
commonly known since the Food and Drug Administration (FDA)
approved Modafinil under the brand name Provigil in 1998.
Adrafinil (Pronounced ah DRAF i nil)
The first commonly available Eugeroic was Adrafinil. It was
invented by the French pharmaceutical company Lafon in the late
1970s, and marketed as Olmifon. It was primarily used as
treatment for inattention and fatigue in elderly patients. Adrafinil
is metabolized by the body to produce Modafinil. For this reason
it takes longer to take effect than Modafinil or Armodafinil and is
less effective. It also has far more side effects, particular on the
liver.
Adrafinil does have the benefit of being almost completely
unregulated worldwide. However, I cannot recommend its use
due to its potentially liver damaging effects. Cephalon, a major
producer of Adrafinil, stopped production in 2011 due to
Adrafinil’s potential risks outweighing its benefits. Just to be
prescribed Adrafinil doctors will normally require you to have
liver tests every 3 months to make sure the damage is not too
extensive.
Modafinil (Pronounced moe DAF i nil)
Lafon went on to invent Modafinil in the 1980’s. It was first made
available for sale in the 1990’s under the names Modalert, Provigil
and Modiodal. Modafinil is known to be faster acting and more
effective than Adrafinil. It is also safer, has fewer side effects, and
there is no known danger of it causing liver damage.
Modafinil was probably the first Eugeroic to become truly popular
for its cognitive enhancing benefits and has been widely reported
on in the mass media. It’s probably the most commonly used
Eugeroic available. In 2001 alone over 1 million people were
prescribed Modafinil in the United States – with just 400,000
people with Narcolepsy in the US it is likely the majority of those
prescriptions were for otherwise healthy people who just wanted
more wakefulness.
Armodafinil (Pronounced ar moe DAF i nil)
Also invented by Cephalon, Armodafinil is the newest and most
refinded Eugeroic currently available. It contains only the main
active ingredient of Modafinil. Armodafinil has been criticized by
some as a cash-grab by Cephalon, calling it a response to their
Modafinil patent expiring. In the US it is sold under the brand
name of Nuvigil. It is produced by Sun Pharma under the generic
name of Waklert.
Armodafinil has benefits over Modafinil in the same way that
Modafinil had benefits over Adrafinil. Armodafinil is more
effective than Modafinil per milligram, lasts longer and has fewer
side effects, making it better for day-to-day use.
Many of the side effects of Modafinil, such as muscle tension,
headaches, anxiety and pressure behind the eyes are reported
less by people using Armodafinil.
PRESCRIBED USES OF MODAFINIL AND ARMODAFINIL
Modafinil and Armodafinil have proven to be truly life changing
medications for those suffering from sleep disorders. Even
though they can be beneficial for a range of different purposes,
they are generally only prescribed for sleep disorders.
Prescribed Uses of Modafinil
Currently Modafinil is approved by the FDA for the treatment of
narcolepsy, obstructive sleep apnea and shift work disorder.
Prescribed Uses of Armodafinil
Currently Armodafinil is approved by the FDA for the treatment of
narcolepsy, obstructive sleep apnea and shift work disorder.
Cephalon, the US patent holder for Armodafinil, attempted to
gain FDA approval for the treatment of jet lag, but was declined.
While the FDA did not release an official reason for declining it for
jet lag it is believed the data submitted by Cephalon was deemed
to show insignificant evidence. The New York Times ran an article
in March 2010 on this story:
http://www.nytimes.com/2010/03/30/business/30drug.html
OFF-LABEL USES
Due to their relative safety and effectiveness, both Modafinil and
Armodafinil have become commonly used to treat a variety of
conditions that they are not officially approved for. In most cases,
both Modafinil or Armodafinil can be used to successfully treat
these conditions.
Off-Label Uses of Modafinil and Armodafinil
- ADHD
Modafinil has been clinically proven to be an effective
treatment for ADHD. Importantly, the FDA found it to be
unsuitable for use in children due to two cases of a skin
rash. It is currently considered one of the best treatments
for ADHD in adults as it lacks the addictiveness of the
alternative treatments.
- Depersonalization Disorder
Modafinil has been reported to be an effective treatment
for depersonalization disorder, although clinical trials have
yet to be carried out. Those with hypersomnia, impaired
attention and under-arousal are most likely to respond to
Modafinil.
- Mood Disorders
Modafinil is a potentially effective treatment for: medication
related fatigue, fatigue from disease, Parkinson’s disease,
schizophrenia, cocaine & opiate dependence, depression
and bipolar depression. It is also reportedly effective at
treating seasonal affective disorder (SAD).
- Cognitive Enhancement
Modafinil is proven to be effective at improving working
memory, and is reportedly effective at improving executive
function, spatial memory and attention. It has also been
shown to have neuro-protective effects in rats.
- Cocaine Addiction
Modafinil has been reported as partially effective at treating
cocaine dependence.
- Fatigue
Perhaps most obviously, Modafinil is used off-label to treat
fatigue from a wide range of disorders including:
o
o
o
o
o
o
o
Fibromyalgia
Chronic Fatigue Syndrome (CFS/ME)
Idiopathic Hypersomnia
Major Somnolence Disorder
Myotonic Dystrophy
Opoid-induced Sleepiness
Parkinson’s Disease
- Spastic Cerebral Palsy
Multiple trials have all shown that Modafinil is effective at
treating spastic cerebral palsy. The list of potential benefits
include:
o
o
o
o
o
Decreased spasticity
Improved walking speed
Improved gait
Reduction in drooling
Improved coordination and speech
- Weight loss
Due to Modafinil’s appetite suppressing and energyincreasing benefits, it has also been proven to be an
effective weight loss medication. In one trial, those taking
200mg a day showed an 18% decrease in caloric intake, and
those taking 400mg showed 38% decrease.
A study of the Modafinil’s effect on a morbidly obese patient
weighing 128kg (280lb) reported that the patient lost 40lb
(20kg) in a year using Modafinil. After 3 years his weight loss
stabilized at 50lb (22kg).
Modafinil is better at suppressing appetite than Armodafinil.
- Shift Work/Military/Law Enforcement
Although Modafinil is officially prescribed as a treatment for
shift work disorder, it has also begun to be used by some
militaries as a way to reduce fatigue and improve alertness.
In the US, tactical paramedics in Maryland have access to
up to 200mg a day.
Astronauts onboard the International Space Station use
Modafinil to optimize their performance, and to relieve
exhaustion caused by reduced sleep and disruptions in
circadian rhythms.
- Jet Lag
Modafinil is commonly used off-label as a way to combat jet
lag. The manufacturer attempted to gain FDA approval for
treating jet lag although the FDA did not accept their
application.
- Exercise
Modafinil has been shown to prolong the time it takes to
reach exhaustion during exercise, and reduces the
perception of effort associated with reaching this limit.
Modafinil is considered to be a prohibited stimulant in
competitions by the World Anti-Doping Agency.
DOSAGE
The following dosage charts should be
considered to be a general guide only. Modifinal
and Armodafinil are prescribed at different
dosages depending on the condition that is being
treated. The tables below provide a rough guide
of ‘normal’ dosages although everyone is different.
If in doubt start with less and build up gradually.
Condition
Narcolepsy
Armodafinil
Recommended Dosage
150mg once daily
Immediately upon waking. Some people find
75mg upon waking and 75mg at lunch works
better if you get tired later in the day.
Idiopathic Hypersomnia
150mg once daily
Immediately upon waking. People with
Idiopathic Hypersomnia often require an
additional 150mg tablet at lunch.
Obstructive Sleep Apnea (OSA)
150mg once daily
Immediately upon waking.
Shift Work Disorder (SWD)
150mg once daily
Approx. one hour prior to starting shift
Spastic Cerebral Palsy
75mg once daily
Immediately upon waking.
Jet Lag
150mg once daily
Best taken at 7 am in the new time zone on
the first day you want to be productive.
Performance Enhancement
75mg once daily
In otherwise healthy individuals
Immediately upon waking. Decrease if
insomnia becomes a problem.
Condition
Narcolepsy
Modafinil
Recommended Dosage
200mg - 400mg once daily
Immediately upon waking. Some people find
100mg upon waking and 100mg at lunch
works better if you get tired later in the day.
Idiopathic Hypersomnia
200mg - 400mg once daily
Immediately upon waking. People with
Idiopathic Hypersomnia often require an
additional 200mg tablet at lunch.
Obstructive Sleep Apnea (OSA)
200mg - 400mg once daily
Immediately upon waking.
Shift Work Disorder (SWD)
200mg once daily
Approx. one hour prior to starting shift
Spastic Cerebral Palsy
100mg - 200mg once daily
Immediately upon waking.
Jet Lag
100mg - 200mg once daily
Best taken at 7 am in the new time zone on
the first day you want to be productive.
Performance Enhancement
100mg - 200mg once daily
In otherwise healthy individuals
Immediately upon waking. Decrease if
insomnia becomes a problem.
It is worth noting that these dosages are for people with specific
medical conditions. Many fit, healthy and well rested people will
find that they can take as little as half or a third of the doses
specified above and receive significant benefits.
MINIMUM EFFECTIVE DOSAGE
Speaking generally with medication like this it is
often better to work your way up to find the ideal
dosage for your needs. Just because the
published data suggests your condition requires a
certain dosage does not mean that is what your
body will respond to.
In starting these medications you have three
choices:
• Start on the recommended dose
• Start higher than the recommended dose
• Start lower than the recommended dose
The consequences to starting too low are a lack of wakefulness,
or little to no perceivable effect. The consequences of starting too
high are a much higher likelihood of side effects. Given these
medications can last 12+ hours when your dose is too high and
you experience the side effects you are likely to be experiencing
them for most of the day!
If you’re to start with a lower dose then you think you will need,
such as half a tablet, you can work your dosage up gradually. Pick
a time when you have a few days without important meetings or
appointments so that you can learn what works best for your
body. If at any time you experience side effects it is a good sign
that your dose is too high – by lowering your dose you might find
the majority of the side effects disappear.
Many people report side effects disappearing after 3~5 days on a
steady dose. For example, many people placed straight onto a
high dose by their doctor will experience a headache. But after
taking the medicine as prescribed for 3~5 days often that
headache will disappear or lessen to the point where it is no
longer a problem.
By finding your ‘minimum effective dosage’ you will not only
avoid the side effects, but you will also get better value from your
purchase. The less you need the longer your medication will last
you!
RISKS
With any medication there are some risks
involved. Risks from using Modafinil and
Armodafinil are statistically low. This is
reflected in their regulation as “Prescription
Only”.
Drugs are categorized by Government
Departments based on their toxicity,
addictiveness and dangers to those who
take them. Generally the safest drugs are
“Over the Counter” (such as Aspirin), then “Prescription Only”
(such as Ibuprofen), then “Restricted” (such as Ritalin) and finally
“Illegal” (such as Heroin).
Modafinil and Armodafinil are not approved for treating children
for any condition. It is not known whether it is safe or effective
for use in people under the age of 17.
Note for the ladies: Armodafinil and Modafinil reduce the
effectiveness of hormonal contraceptives. These effects may last
for up to 1 month after cessation of dosage. There is no reduction
in the effectiveness of condoms or non-hormonal birth control.
When should I not take Modafinil?
In general, if you are:
- Under the age of 18
- Taking hormonal contraceptives
- Pregnant or breastfeeding
- Taking other medications known to interact (See Appendix 1)
- Experiencing cardiovascular diseases/problems
- Morbidly obese
- Allergic to any of the following:
o Modafinil
o Armodafinil
o Lactose monohydrate
o Microcrystalline cellulose
o Pregelatinized starch
o Croscarmellose sodium
o Povidone
o Magnesium stearate
SIDE EFFECTS
Side effects: Modafinil
Modafinil is generally recognized as having more side effects than
Armodafinil.
Common side effects include:
- Muscle pain
- Headache
- Nausea
- Nervousness
- Slight feeling of pressure behind the eyes
- Diarrhea
- Anxiety
- Dizziness
- Trouble sleeping
- Dry mouth
- Loss of appetite
More serious side effects can include:
- Serious rash or skin reaction
- Serious allergic reaction involving the liver or blood cells
- Hives
- Mouth sores
- Trouble swallowing or breathing
- Fever
- Shortness of breath
Any of these serious side effects may need to be treated in a
hospital and may be life-threatening. If you develop a skin rash,
hives, sores in your mouth, blisters, peeling, or yellowing of your
skin or eyes, trouble swallowing or breathing, dark urine, or fever,
stop taking Modafinil and call your doctor right away.
Modafinil has been reported in rare cases to cause a number of
life threatening conditions including Stephens-Johnson Syndrome
(SJS), Toxic Epidermal Necrolysis (TEN) and DRESS syndrome.
Psychological effects
Adverse psychological events associated with the use of Modafinil
can include mania, delusions, hallucinations, suicidal ideation and
aggression. Many, but not all, patients studied had a prior
psychiatric history. One healthy male volunteer developed ideas
of reference, paranoid delusions, and auditory hallucinations in
association with multiple daily 600 mg doses of Modafinil and
sleep deprivation. There was no evidence of psychosis 36 hours
after drug discontinuation.
In the adult modafinil controlled trials database, psychiatric
symptoms resulting in treatment discontinuation (at a frequency
≥0.3%) and reported more often in patients treated with
modafinil compared to those treated with placebo were anxiety
(1%), nervousness (1%), insomnia (<1%), confusion (<1%),
agitation (<1%), and depression (<1%). Caution should be
exercised when Modafinil is given to patients with a history of
psychosis, bipolar, depression, or mania.
Side effects: Armodafinil
Armodafinil is generally recognized as having less side effects
than Modafinil.
Common side effects include:
- Headache
- Nausea
- Nervousness
- Diarrhea
- Anxiety
- Dizziness
- Trouble sleeping
More serious side effects can include:
- Serious rash or skin reaction
- Mouth sores
- Trouble swallowing or breathing
- Fever
- Shortness of breath
Any of these serious side effects may need to be treated in a
hospital and may be life-threatening. If you develop a skin rash,
hives, sores in your mouth, blisters, peeling, or yellowing of your
skin or eyes, trouble swallowing or breathing, dark urine, or fever,
stop taking Modafinil and call your doctor right away.
Armodafinil has never been reported to cause life threatening
conditions.
As Armodafinil is a newer medication less is known about the side
effects it may cause. A great deal of the safety data they have
discovered with Modafinil has contributed to the low number of
adverse reactions with Armodafinil in the literature.
FURTHER INFORMATION
As time passes it is inevitable that more will become known about
Modafinil, Armodafinil and possibly future versions of these
drugs.
The most current public source of information relating to these
drugs is their respective Wikipedia pages:
• Modafinil on Wikipedia:
http://en.wikipedia.org/wiki/Modafinil
• Armodafinil on Wikipedia:
http://en.wikipedia.org/wiki/Armodafinil
If you would like to receive email updates when this guide is
updated or emails about changes in the medical knowledge
relating to these drugs then you can subscribe for free here:
http://www.getsmartnow.in/get/safetyguide/
(scroll to the bottom of the page for instructions)
SUMMARY
Thanks for reading! Hopefully you’ve found this Safety Guide
useful in informing your usage of Modafinil and Armodafinil.
If you only remember two things, remember:
• Find your Minimum Effective Dosage – get the most from
your medication and minimize your risks of side effects.
• Consult your doctor if you experience any adverse
effects – this medication is fairly safe, though nothing is
more important than your health. If in doubt about your
safety then get in touch with your nearest doctor!
Included as a little bonus is an Appendix including all of the
known Drug Interactions between Modafinil and Armodafinil. This
information is sourced from Epocrates and is definitely worth a
read. Make sure you check using the active ingredients of your
other medication rather than just the brand name. You will notice
that even Caffeine makes the list.
Since you’ve read this far I would like to reward you with a
coupon code if you decide to order Armodafinil or Modafinil
online from one of my websites. If you use this coupon code you
will receive 10 bonus tablets on your order. The coupon code is:
GUIDE10BONUSMODA
(this will include 10 bonus Modafinil tablets)
GUIDE10BONUSARMODA
(this will include 10 bonus Armodafinil tablets)
A list of websites offering these medications can be found on:
http://www.getsmartnow.in/
APPENDIX 1: DRUG INTERACTIONS
Most drugs will interact to an extent with other drugs. What
follows in this appendix is a list of the drugs that are known to
interact with modafinil and armodafinil. These interactions
include identified and evidence-based theoretical interactions
that are both pharmacokinetic and pharmacodynamic in nature,
with the exception of those based primarily on intended
therapeutic effects.
Drug Interactions are organized according to clinical
management and utilize such categories as "Contraindicated",
"Avoid/Use Alternative", "Monitor ", and "Caution Advised". If you
are unsure about how your current medication might interact
with this medication then consult your health care professional.
Note: These lists are not complete and other drugs may have been found to
interact since this information was released. Before taking any new
medication you must consider all medications you take including
prescription, over-the-counter, vitamins and herbal products.
Drug Interactions: Modafinil
Modafinil:*Contraindicated*(1)*
ranolazine
*
Modafinil:*Avoid/Use*Alternative*(36)*
atazanavir
axitinib
clopidogrel
contraceptives, oral
combo
contraceptives, oral
progestin
contraceptives,
other combo
darunavir
dasatinib
delavirdine
dronedarone
emtricitabine/
rilpivirine/
tenofovir
disoproxil
erlotinib
etonogestrel
(contraceptive)
fosamprenavir
indinavir
irinotecan
itraconazole
ixabepilone
ketoconazole
lapatinib
levonorgestrel (postcoital contraceptive)
lopinavir/ ritonavir
mifepristone
nelfinavir
nilotinib
pazopanib
rilpivirine
ritonavir
saquinavir
sunitinib
telithromycin
temsirolimus
tipranavir
tolvaptan
ulipristal (post-coital
contraceptive
medroxyprogesterone
(contraceptive)
Modafinil:*Monitor*(45)*
acebutolol
aliskiren/
amlodipine
aliskiren/
amlodipine/
hydrochlorothiazide
amlodipine/
ARB
combos
amlodipine/
atorvastatin
aripiprazole
atenolol
atenolol/
chlorthalidone
betaxolol
bisoprolol
bisoprolol/
hydrochlorothiazide
calcium
channel
blockers,
dihydropyridines
calcium
channel
blockers, others
carbamazepine
carvedilol
cinacalcet
citalopram
cyclosporine
disopyramide
esmolol
ethosuximide
gefitinib
labetalol
methadone
metoprolol
metoprolol/
hydrochlorothiazide
nadolol
nadolol/
bendroflumethiazide
nebivolol
penbutolol
phenytoin
pindolol
propranolol
propranolol/
hydrochlorothiazide
quinidine
repaglinide
repaglinide/
metformin
sirolimus
sotalol
tacrolimus
theophylline
tiagabine
timolol
tofacitinib
warfarin
Modafinil:*Caution*Advised*(112)*
acetaminophen/
aspirin/ caffeine
acetaminophen/
caffeine
acetaminophen/
caffeine/
CNS
depressant combos
acetaminophen/
magnesium salicylate/
pamabrom
acetaminophen/
pamabrom
alfentanil
alpha 2 agonists/
beta
blockers,
ophthalmic
amiodarone
aprepitant
artemether/
lumefantrine
aspirin/ caffeine
atovaquone/
proguanil
barbiturates
benzodiazepines,
CYP3A4 substrates
beta
blockers,
ophthalmic
bexarotene
boceprevir
bortezomib
bosentan
bromocriptine
buprenorphine
buspirone
cabazitaxel
caffeine
carisoprodol
carisoprodol/ aspirin
carisoprodol/
aspirin/ codeine
chloramphenicol
cisapride
clarithromycin
clomipramine
clozapine
CNS
depressant/
aspirin/
caffeine
combos
cobicistat
colchicine
conivaptan
corticosteroids,
systemic
dapsone
darifenacin
desipramine
diazepam
docetaxel
donepezil
doxepin
doxorubicin
efavirenz
efavirenz/
emtricitabine/
tenofovir disoproxil
enzalutamide
eplerenone
ergotamine/ caffeine
erythromycin
eszopiclone
etravirine
everolimus
fentanyl
fluvoxamine
ifosfamide
imatinib
imipramine
levonorgestrel
intrauterine
device
(contraceptive)
linezolid
MAOIs, all
maraviroc
meperidine
nefazodone
nevirapine
niacin/ lovastatin
niacin/ simvastatin
oxycodone
oxycodone/
acetaminophen
oxycodone/ aspirin
oxycodone/
ibuprofen
paclitaxel
pamabrom
pentamidine
phenobarbital/
hyoscyamine/
atropine/ scopolamine
pimozide
ponatinib
posaconazole
propoxyphene
propoxyphene/
acetaminophen
quetiapine
quinine
rifabutin
rifampins
rifapentine
risperidone
romidepsin
ruxolitinib
sildenafil
sitagliptin/
simvastatin
solifenacin
sorafenib
St. John’s wort
statins,
CYP3A4
substrates
stimulants
and
anorexiants
sufentanil
tadalafil
tamoxifen
telaprevir
teniposide
thiotepa
toremifene
tramadol
tramadol/
acetaminophen
trazodone
vardenafil
vinca alkaloids
voriconazole
zaleplon
ziprasidone
zonisamide
Drug Interactions: Armodafinil
Armodafinil:*Contraindicated*(1)*
ranolazine
Armodafinil:*Avoid/Use*Alternative*(36)*
atazanavir
axitinib
clopidogrel
contraceptives, oral
combo
contraceptives, oral
progestin
contraceptives,
other combo
darunavir
dasatinib
delavirdine
dronedarone
emtricitabine/
rilpivirine/
tenofovir
disoproxil
erlotinib
etonogestrel
(contraceptive)
fosamprenavir
indinavir
irinotecan
itraconazole
ixabepilone
ketoconazole
lapatinib
levonorgestrel (postcoital contraceptive)
lopinavir/ ritonavir
mifepristone
nelfinavir
nilotinib
pazopanib
rilpivirine
ritonavir
saquinavir
sunitinib
telithromycin
temsirolimus
tipranavir
tolvaptan
ulipristal (post-coital
contraceptive)
medroxyprogesterone
(contraceptive)
Armodafinil:*Monitor*(45)*
acebutolol
aliskiren/
amlodipine
aliskiren/
amlodipine/
hydrochlorothiazide
amlodipine/
ARB
combos
amlodipine/
atorvastatin
aripiprazole
atenolol
atenolol/
chlorthalidone
betaxolol
bisoprolol
bisoprolol/
hydrochlorothiazide
calcium
channel
blockers,
dihydropyridines
calcium
channel
blockers, others
carbamazepine
carvedilol
cinacalcet
citalopram
cyclosporine
disopyramide
esmolol
ethosuximide
gefitinib
labetalol
methadone
metoprolol
metoprolol/
hydrochlorothiazide
nadolol
nadolol/
bendroflumethiazide
nebivolol
penbutolol
phenytoin
pindolol
propranolol
propranolol/
hydrochlorothiazide
quinidine
repaglinide
repaglinide/
metformin
sirolimus
sotalol
tacrolimus
theophylline
tiagabine
timolol
tofacitinib
warfarin
Armodafinil:*Caution*Advised*(112)*
acetaminophen/
aspirin/ caffeine
acetaminophen/
caffeine
acetaminophen/
caffeine/
CNS
depressant combos
acetaminophen/
magnesium salicylate/
pamabrom
acetaminophen/
pamabrom
alfentanil
alpha 2 agonists/
beta
blockers,
ophthalmic
amiodarone
aprepitant
artemether/
lumefantrine
aspirin/ caffeine
atovaquone/
proguanil
barbiturates
benzodiazepines,
CYP3A4 substrates
beta
blockers,
ophthalmic
bexarotene
boceprevir
bortezomib
bosentan
bromocriptine
buprenorphine
buspirone
cabazitaxel
caffeine
carisoprodol
carisoprodol/ aspirin
carisoprodol/
aspirin/ codeine
chloramphenicol
cisapride
clarithromycin
clomipramine
clozapine
CNS
depressant/
aspirin/
caffeine
combos
cobicistat
colchicine
conivaptan
corticosteroids,
systemic
dapsone
darifenacin
desipramine
diazepam
docetaxel
donepezil
doxepin
doxorubicin
efavirenz
efavirenz/
emtricitabine/
tenofovir disoproxil
enzalutamide
eplerenone
ergotamine/ caffeine
erythromycin
eszopiclone
etravirine
everolimus
fentanyl
fluvoxamine
ifosfamide
imatinib
imipramine
levonorgestrel
intrauterine
device
(contraceptive)
linezolid
MAOIs, all
maraviroc
meperidine
nefazodone
nevirapine
niacin/ lovastatin
niacin/ simvastatin
oxycodone
oxycodone/
acetaminophen
oxycodone/ aspirin
oxycodone/
ibuprofen
paclitaxel
pamabrom
pentamidine
phenobarbital/
hyoscyamine/
atropine/ scopolamine
pimozide
ponatinib
posaconazole
propoxyphene
propoxyphene/
acetaminophen
quetiapine
quinine
rifabutin
rifampins
rifapentine
risperidone
romidepsin
ruxolitinib
sildenafil
sitagliptin/
simvastatin
solifenacin
sorafenib
St. John’s wort
statins,
CYP3A4
substrates
stimulants
and
anorexiants
sufentanil
tadalafil
tamoxifen
telaprevir
teniposide
thiotepa
toremifene
tramadol
tramadol/
acetaminophen
trazodone
vardenafil
vinca alkaloids
voriconazole
zaleplon
ziprasidone
zonisamide